Texas hospital turns down obese job applicants

Experts debate whether policy is legal, appropriate

Topics: Health and Wellness, Benefits, Labor Expense, Workforce, Staffing

March 27, 2012

A Texas hospital prohibits hiring obese employees, a policy it says is consistent with offering high-quality patient care and maintaining employee wellness, the Texas Tribune reports.

Victoria, Texas-based Citizens Medical Center instituted the policy—which requires potential employees to have a body mass index (BMI) of less than 35—a little more than one year ago. For example, an individual who is 5 feet 5 inches could not weigh more than 210 pounds, while a prospective staff member who is 5 feet 10 inches could not weigh more than 245 pounds.

According to the policy, an employee’s physique "should fit with a representational image or specific mental projection of the job of a health care professional" and should not distract patients.

Under the policy, physicians screen potential employees to assess their fitness level. According to Citizens CEO David Brown, some candidates have been rejected for being overweight, but current employees who become overweight across their tenure are not terminated and are offered help to improve their wellness.

Is weight the right metric?
"The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance," Brown said. "We have the ability as an employer to characterize our process and to have a policy that says what's best for our business and for our patients."

In addition, Brown said that excessive weight may have negative effects on the hospital's health plan, adding that there is evidence that obese employees are absent from work more frequently.

However, a Citizens physician—who declined to be identified—acknowledged that overweight employees and patients cost the health system more; however, he noted that BMI may be an inaccurate indicator of overall health in some situations. For example, a professional football player may have a BMI of 32 but only have 7% body fat.

A common practice?
Although the Texas Hospital Association (THA) and the American Hospital Association said they have seen an increasing number of facilities who will not hire smokers, they have not heard of any other hospitals restricting hiring based on weight or BMI.

THA spokesperson Lance Lunsford noted that the policy could increase the hospital's risk for litigation. "There is an indication that not hiring someone due to obesity might be successfully challenged in court," Lunsford said. For example, the Tribune notes that some court rulings have determined that obesity is a disability, which is protected under the Americans with Disabilities Act.

However, employment lawyers say Citizens' hiring policy is legal. "In Texas, employers cannot discriminate against employees because of their race, age, or religion," said employment attorney DeDe Church. "Weight is not one of those protected categories." Only Michigan and six U.S. cities, including San Francisco and Washington, D.C., prohibit weight-based hiring restrictions (Ramshaw, Tribune, 3/26).

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